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DNT final3

DNT final topics

QuestionAnswer
L-Glutamine Biochemistry predominant amino acid in the bloodstream (nitrogen transport). Nutrient for enterocytes and immune system cells.
L-Glutamine Indications Surgery/critical dz (recovery), Chemo support,
L-Glutamine Dietary sources/dosages beef, chicken, fish, beans, dairy, beets, cabbage; dosage: 1-30g/day
L-Glutamine Interactions Pv chemo side-effects, antagonize lactulose, <Diarrhea from HIV drug
L-Glutamine Toxicity Exacerbates Crohn's Dz sxs
S-adenosyl-L-methionine Biochemistry methyl donor in pathways that form nucleic acids, proteins, phospholipids, and neurotransmitters
S-adenosyl-L-methionine Indications Osteoarthritis (anti-inflammatory), Depression, Liver Dz (Cholestasis)
S-adenosyl-L-methionine Dietary sources/Dosage 400-1600mg/day
S-adenosyl-L-methionine Interactions Anti-depressants (faster effect ofmeds) , Hepatitis C (improves viral response)
S-adenosyl-L-methionine Toxicities Bipolar Dz (Sxs of mania and hypomania), GI upset
Phenylalanine Biochemistry building block for several of the neurotransmitters, including L-dopa, norepinephrine, epinephrine, melanin (L-isomer) and phenylethylamine (D-isomer)
Phenylalanine Indications Chronic Pain, Depression, Parkinson's Dz, Vitiligo,
Phenylalanine Dietary sources/Dosage -Sources:beef, poultry, pork, fish, dairy, eggs, soy, aspartame. Dose: 50-2500mg/day
Phenylalanine Interactions Aspartame sweetener increase Phe levels (-migraine), MAOI, levodopa, neuroleptics
Phenylalanine Toxicities CI in PKU patients
N-acetylcysteine Biochemistry More easily absorbed cysteine which is limiting factor in glutathione production.
N-acetylcysteine Indications COPD/Mucolytic agent (chronic bronchitis), Acute LV failure (acetomenophen overdose), Glutathione support, Chemo-support, Psychiatric anxiolytic(OCD, Bipolar, Schizophrenia)
N-acetylcysteine Dietary sources/Dosage -Sources: poultry, yogurt, oats, wheat germ, egg yolk, red pepper, garlic, onions, broccoli, and Brussels sprouts -Dosages:600-1200mg/day
N-acetylcysteine Interactions Inactivates chemo's cytotoxicity, Chelate Zn + Cu, Headache w/ Nitroglycerin (vasodilation)
N-acetylcysteine Toxicities GI upset, gas/bloating/abd. pain
Iodine Biochemistry key constituent of the thyroid hormone molecules
Iodine Indications Disinfectant, Iodine deficiency (hypothyroidism, multinodular goiter, neurological development), Thyroid storm
Iodine Dietary sources/Dosage Sources:sea vegetables (kelp), yogurt, cow’s milk, eggs, strawberries, mozzarella cheese, iodized table salt -Dosages:adults:150mcg, pregnant: 225mcg, UL: 1,100mcg/day SSKI (saturated solution potassium iodide), Lugol's iodine (KI + elemental iodine)
Iodine Testing Urinary test for deficiency assessment (Thyroglobulin levels up in I deficiency), Iodine load test not valid test
Iodine Interactions Babies on soy formulas have goitrogenic effect, avoid dietary iodine x2weeks before starting radioactive iodine treatment.
Iodine Toxicities Burning of the mouth, GI distress, and circulatory collapse. Autoimmune thyroid dz, impaired thyroid production/function (Wolff-Chaikoff effect)
Iodine Deficiency goiter, hypothyroidism, hyperthyroidism. Deficiency is most common where soil iodine is lowest (Pacific Northwest, Great Lakes)
Melatonin Biochemistry Antioxidant. An amino acid-based hormone produced in the brain from tryptophan → Serotonin.
Melatonin Indications Insomnia (delayed sleep)-developmental d/o, Metastatic cancer (appetite/weight maintenance/immune function), Jet lag, Cluster/tension headache, Sarcoidosis
Melatonin Dietary sources/Dosage : Dosage:3-5mg/day taken 30-60 minutes before bedtime. Controlled release form.
Melatonin Interactions Fluoxetine action inhibited, NSAIDS inhibit melatonin synthesis
Melatonin Toxicities Nightmares
Coenzyme Q10 Biochemistry (aka ubiquinone) key component of the electron transport chain
Coenzyme Q10 Indications CVD (congestive Ht failure-100mg w/ carnitine, Angina, Acute MI), HTN-dec. 17mmHg Sys, 10mmHg Dia. Parkinson's Dz, Migraine, Mitochondrial myopathy,
Coenzyme Q10 Dietary sources/Dosage 30-1200mg in fat emulsified versions of CoQ10 (CarniQ gel from Tishcon). ITI's wafers. Vitaline, Q Gel
Coenzyme Q10 Interactions Reversible cardiomyopathy w/ statins in Diabetics
Coenzyme Q10 Deficiencies cardiomyopathy, arrhythmia, angina and hypertension, gingiva and stomach ulcers
L-Carnitine Biochemistry shuttles fatty acids into the mitochondria for oxidation, enhances the activity of cholinergic and dopaminergic neurons in the CNS, and increases the synthesis of nerve growth factor (NGF) and the expression of NGF receptors.
L-Carnitine Indications CVD (Angina, HTN, MI, CHF (class III->class II)), Renal failure (increases weight, dec. itching) Non-alcoholic steatohepatosis, Hepatic encephalopathy, Hyperthyroidism/storm, Fatigue in Fibromyalgia/chronic fatigue/cancer.
L-Carnitine Dietary sources/Dosage Sources: Meat, milk, eggs and dairy. Dosages:500mg-4g/day Acetyl-L-carnitine (ALC) used in trials, but differences from cheaper L-carnitine not clear.
L-Carnitine Interactions Reduced fatigue associated w/ inteferon for Hep C and anti-convulsant meds
L-Carnitine Toxicities Heartburn?, unpleasant body odor, hypertension, nausea or vomiting, abdominal pain and diarrhea.
L-Carnitine Deficiencies impaired fatty acid oxidation
Probiotics Biochemistry Help to repopulate or restore normal intestinal bacterial flora
Probiotics Indications Functional GI complaints (constipation, diarrhea), Reduce C. difficile recurrence, BV, Vaginal candidiasis, IBS (w/ fiber), IBD (Crohn's/UC), Immunity (allergic rhinitis), Eczema, lactose digestion.
Probiotics Dietary sources/Dosage Sources: fermented foods; yogurt, kefir, sour cream, tempeh, sauerkraut, kimchi, miso and kombucha -Dosages: Live and dead organisms show no difference in effect. Lactobacillus, Sacromyces boulardii 500mg BID (more expensive), Brewer's yeast 3-15g/day
Probiotics Toxicities Contraindicated in severe acute pancreatitis. Serious infections in immunocompromised patients
Probiotics Deficiencies Occurs with antibiotic usage and can contribute to increase gut permeability, leaky gut syndrome, dysbiosis, abdominal distention, bloating, abdominal cramping, loose stools, fatigue, constipation, and acute/chronic diarrhea.
Alpha-lipoic acid Biochemistry (aka thioctic acid, alpha lipoate) antioxidant soluble in water and fat, functions as a cofactor in energy-producing metabolic reactions and may improve recycling of additional antioxidant compounds such as vitamin C, vitamin E, glutathione, coenzyme Q10
Alpha-lipoic acid Indications Diabetic neuropathy (200mgBID), Amanita mushroom poisoning, HIV, Burning mouth syndrome
Alpha-lipoic acid Dietary sources/Dosage Sources: broccoli, spinach, collard greens, chard, tomatoes, potatoes and red meats -Dosage: Common doses are 200-600BID orTID, Clinical trials: 150-1800mg
Alpha-lipoic acid Interactions Chelates minerals esp. Cu -danger to nervous system,
Alpha-lipoic acid Toxicities To avoid toxic effect, administer thiamine or vitamin B-complex pre-treatment
Created by: phdinh33